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BILL 4F LADING <br /> 3909 Park Road, Suite D <br /> NTAL SERVICES Benicia, CA 94510 <br /> IGROUP (877) 748-3040 r <br /> Western Region <br /> DELIVERY DATE JOB# <br /> r y <br /> SHIPPER 1 CUSTOMER POINT OF CONTACT <br /> M t' t -,; r i A* , <br />.DDRESS PHONE# <br /> •+ 7 it <br /> ITY STATE ZIP <br /> : i X',-O LU r'A <br />-48RIER 1 TRANSPORTER PHONE# <br />.ONSIGNEE I FACILITY POINT OF CONTACT <br /> .1Tr WP L4 f =t <br />+DDRESS PHONE# <br />.ITY STATE ZIP <br /> dila E Ii` oz_ •~ ' _ } <br />,pecial Handling instruction and Additional Information <br /> GJ <br /> Macards Provided YES NO Emergency Phone#(877) 748-3040 <br />,HIPPER S CERTIFICATION i hereby declared Mat the contents of this consignment are fully and accurately described above by proper shipping name and are classrtled packed <br /> narked and labeled,and are in all respects in proper condtbon for transport by highway vessel and rail acwfding to applicable mtemabonal and national government regulations <br /> SHIPPER)PRINT OR TYPE NAME,�` p v - -SIGNATURE _' r } �_ r+iotfm DAY Yens <br /> C S„ RANSPORTER)PRINT OR TYPE f4AME SIGNATURE Moan+ DAY YEAR <br /> CONSIGN> E/FAC ITY)PRINT QR TYPE NAME SIGNATURE wiaan+ D" Yew <br /> C X <br /> orm#PSC-201-RV 6104 1 <br /> CARRIER <br />